Unlocking Success with the KPIs Behind a $20.4 Million Home Care Business

Unlocking Success with the KPIs Behind a $20.4 Million Home Care Business

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Ruby Mehta: Hello and welcome to CareSmartz On Air, a home care podcast. I am Ruby Mehta, VP of Sales at Caresmartz. Today we have a very special guest. Emily Isbell.

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Ruby Mehta: the chief executive officer of Emily Isbell, and Company. Emily has a truly remarkable story. Having worked her way from the bottom to the top of one of the leading franchisees home instead, during her time at home. Instead, Emily demonstrated exceptional leadership skills, overseeing multiple franchisees and growing them by double digits. Year after year

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Ruby Mehta: she was a pioneer in the industry, becoming one of the most non-owner leaders to manage more than one franchisee simultaneously.

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Ruby Mehta: all while ensuring that each business continued to flourish independently.

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Ruby Mehta: Emily’s secret to success was her ability to develop high performing teams and implement scalable processes that maintained incredible service quality for clients.

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Ruby Mehta: Now Emily is bringing her expertise to Emily Isbell and Company, where she and her team are helping others grow their revenue and spend more time with their families, with over 15 years of experience in the industry. Emily’s systematic approach to leadership and operations is truly transformative.

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Ruby Mehta: Join us as we dive into Emily’s inspiring journey and learn how she is revolutionizing the way businesses operate.

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Ruby Mehta: welcome to the podcast Emily, how are you?

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Emily Isbell: I am doing well, Ruby, thank you so much for having me.

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Ruby Mehta: Thank you for joining in.

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Ruby Mehta: Let’s get straight to it, Emily. We have been following your journey, and it’s quite impressive. So let’s start with your experience at home instead, share with our audience the key performance indicators that were critical to growing the home, instead, franchising you, oversaw to a combined 20.4 million in annual revenue.

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Emily Isbell: So it’s a long list, and it can be a little bit too much for a starting out home care owner. So I’m just going to highlight, a few that I have found that have been light bulb moments for clients that I’ve worked with, and also, I like to think, in hours versus revenue now. And so that was equated to about a million hours of care. And if you do want to convert that to revenue, it’s around 35 million in today’s economy. And so

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Emily Isbell: I do think Kpis are a key part of success and actually utilizing them. Well.

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Emily Isbell: and I’ll so just to highlight in on the ones that I want to share. The 1st one that I want to share is a lot of people tend to keep track of client losses. So the number of clients that were inactivated, deactivated terminated whatever your software chooses to call it in the previous week month or during that previous year. That’s very common. If people are tracking that, it’s not common, it’s very common to track

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Emily Isbell: that. However, I think one a light bulb moment with a lot of my clients, and what we started doing is tracking the difference between controllable and non-controllable and having conversations around that. So your software may not be able to know why the client

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Emily Isbell: is no longer with you, but you can tell it what to know, and you can identify those clients accordingly, and being able to see how many controllable losses you had, and having a definition with you and your team on what constitutes controllable, I kind of say oftentimes the only non-controllable is if somebody passes. But that’s a little bit of an off the cuff a bit too much of a

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Emily Isbell: blanket statement. But there are times where a controllable loss occurs, and there’s times where a non-controllable occurs that in another situation might be controllable. So, for example, I’ll give, if a client moves to live with their daughter 3 States away. You could argue that it’s non-controllable because they’re no longer in your territory.

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Emily Isbell: But then you peel back the layers, and it’s why did they decide to move to live with their daughter? What changed from the time that they started their journey with our home Care company to now they want to live with their daughter, and depending on the

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Emily Isbell: evaluation of that, it may be controllable. It may be non-controllable, and so it arguably, is a subjective measure, but it forces looking through a lens of more reflection and trying to see what you can do in your business, to better keep clients longer. Term in home and with your services. Another quick example is caregivers paid is a good example

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Emily Isbell: that we started to track versus just paying attention to net gain, which is a common one that a lot of owners keep up with. But even some owners don’t think to do that, and they only pay attention to the number of hired caregivers, and they’re not paying attention to the loss. So the different layers of that is, you start with number of hired caregivers in a particular period, and then you start paying attention to how many were lost, and what’s the net gain or

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Emily Isbell: loss between those numbers? And then you fast forward to the caregiver paid, which is really, who’s actually working? Who’s actually going to assignments and getting paid and serving your company. So that’s a key Kpi, that we started to track and pay attention to closely. Another one that I think.

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Emily Isbell: is often just ignored is a way to track online reviews, knowing how many online reviews are coming in from client satisfaction

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Emily Isbell: during a certain period, having a goal of a certain amount each month, not because you’re forcing, twisting their arm. But your team understands the value of that online review. So when they call to say, Thank you so much for what you did with my mom. I can’t believe we wouldn’t have been able to do this without you and the caregiver Susie, that came that your team member then quickly responds with

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Emily Isbell: gratitude that they’re saying, Thank you, and then ask, Hey, can I send you an email with a link to do that, to give a review to shout out Susie on our Google reviews, and they actually are checking that off the box of a kpi within their within the organization. So those are just a few. I could go on for days about this, but I think for for people to soak it in and actually apply it. I’m going to keep it to those 3, for right now.

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Ruby Mehta: Yeah, no, thank you for that. I think Kpi is one thing, and then the way the Kpis can be achieved so organically, that’s another way. Absolutely. You touched on both, actually, which is great. Then you’re not just doing it because you have to check the box. You are doing it at the right time. You’re collecting feedback at the right time, and you’re collecting the right feedback.

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Emily Isbell: Exactly.

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Ruby Mehta: Yeah, so that’s really interesting.

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Emily Isbell: And I think I’ll circle back and say is, when I say we had a lot of kpis that we measured. That’s not exactly like

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Emily Isbell: the solution you can actually be to overwhelm your team, your staff with too many. So really, it’s when I say we had a lot. We were built to that, and we made sure that everyone, we added was treated with the same level of respect as the previous ones. And so I think it’s building blocks and making sure it’s palpable for people to measure and so start small. Start somewhere. But start small if you’re not doing any Kpi tracking at this time.

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Ruby Mehta: Yeah, yeah.

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Ruby Mehta: my next question is actually related to to that.

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Ruby Mehta: To measure Kpis, you have to have solid processes and tools and technology, or some sort of way to organize everything.

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Ruby Mehta: So what? Were some of the processes or systems or tools that you implemented to ensure growth

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Ruby Mehta: and consistent service quality across multiple franchisees that you dealt with.

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Emily Isbell: Yeah. So I think,

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Emily Isbell: I like this question because there is. You know how people talk about like their overnight Ahas, I actually have one of those like most people. When I used to hear that I’d be like that has never happened to me. It did happen to me, and I only recognize it in hindsight, though. So all that to say that this process that I’m going to share with you was

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Emily Isbell: a big game changer on us on our ability to scale, and especially for me to spread myself between multiple organizations, even though I wasn’t working 40 h in each. I was having the impact of 40 h in each because of this process. And so what

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Emily Isbell: 2 things I want to point out, one having a culture of debriefing that’s not the Aha! I’ll get to the Aha in a minute. But I do want to mention that just having a culture of debriefing where the team is just used to

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Emily Isbell: evaluating the results, and has a natural posture of attacking the problem and not the person. So if there’s a challenge in the business that everybody just knows. Hey, we’re going to hit this head on. And it’s not personal. It’s how can we do differently? Next time in my own organization today, I sent the practice of that

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Emily Isbell: to 3 team members over something that happened. And so it’s a culture here now. And it was a culture then, and that existed in place. That was not the Aha moment, but having that is a key foundation to having good solid results with Kpis. In the 1st place, because if you don’t already have a reflective look at those results, then those numbers are just numbers on a spreadsheet or on a document somewhere.

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Emily Isbell: So that’s 1. But then the Aha moment was in 2016. I almost called it quits. And I talk about this in my book, the 24, 7 solution

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Emily Isbell: to keep this story short, I had shared, shown an owner, a prospective owner around the office and given a tour, and that was the plan we were going to sell and fast forward. I had an overnight moment of waking up and realizing the quote I use in my book is, if I could fix it for them. I could fix it for me, and I’m going to keep from going down that rabbit hole just to make sure we stay on topic. But all that to say

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Emily Isbell: that I figured out many things that I needed to do in the business to make a difference in terms of processes, so that I could actually have a normal work life. And so

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Emily Isbell: one of those was implementing end of day reports. And what this is, it is what it sounds like. It’s a report that you would send to your supervisor on the results you had that day. There is negative feedback sometimes that this may be seen like micromanaging. And I really think that’s

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Emily Isbell: that’s a barrier or a limiting belief that the leader or the owner might have about it. Or if there is team members that don’t like it. Then I have to wonder if

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Emily Isbell: why they don’t like it. Is it because they don’t want to be seen? They don’t want their lack of productivity exposed, because other people, high achievers

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Emily Isbell: are proud and excited to share their end of day report on all that they accomplished during a day. So, having end of day reports was a key part, I talk a lot about subtle accountabilities. It’s the idea that you don’t actually have to directly say to someone.

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Emily Isbell: Did you do, X, you create structures in place that hold them accountable. And it’s subtle. It’s not. It’s not confrontational. And they report out, and so end of days really highlight that, and for overachievers, they they get excited behind them.

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Emily Isbell: And so whenever in 2016, I about called it quits fast forward that later that year I had a complete 180. And actually we took over a second location. This was when I 1st started expanding beyond just one office, and I took over a second location and truly worked part-time in both offices, and I’m not going to say I never worked over 40 h, but I definitely didn’t exhaust myself, and a big part of that was end of day reports

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Emily Isbell: that were coming to me that answered most of the questions I had about the operations through the structure I had in those end of day reports.

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Ruby Mehta: Yeah. And it’s it’s amazing that how you how you said it end of day reports could be

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Ruby Mehta: taken as a as a negative approach of managing and being called a micromanager very easily.

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Ruby Mehta: If and yeah, it’s it’s it’s great that you get. And but for leaders it’s really important. And even for high achievers. I agree they they want to talk about their accomplishments.

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Emily Isbell: Yeah.

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Ruby Mehta: And they don’t want to wait until the end of the week for your weekly reviews, or whatever practices that people have. They want to talk about it right away. I did this today, and I’m proud of it. So it’s amazing. But yes, many people don’t realize how important those accomplishments are especially for someone who is achieving and doing great. They want to be heard.

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Emily Isbell: Yeah. And I think something. I tell my clients a lot that I taught my team. Whenever anybody was new to the team, I would explain the end of day reports this way, and I have. When I was in college and high school, I worked in the restaurant industry, and so a lot of people have had that background. And so I would simply say, this is like rolling the silverware. You can’t go home until you roll the silverware. In reality it’s a 10 min.

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Emily Isbell: 15 min exercise. It may not be joyful at times. You may just want to get home, but we’re talking 10 or 15 min of, and it’s invaluable the results that come from it. But yeah, it’s a closing of duties. It’s a book into your day. So for over for the people that want to be proud. They’re proud for the people who want to just be like, I want to get home. Well, you gotta roll your silverware. We still need to know the results of your day.

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Ruby Mehta: Absolutely. Yes, yes. And when you took that second office it’s a lot of work, obviously managing 2 offices and being a leader, stay on top of everything. How did you really ensure that your teams are flourishing independently, and you can take on more responsibility. How did you ensure that everything was smooth.

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Emily Isbell: Yeah, that’s a good question. So to answer that last question, I said that I was able to, through those end of day reports, understand what happened in the operations. It was one sided I was able to see and not be out of the loop. But, more importantly, and what trans

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Emily Isbell: fired over time is that we shifted that end of day report to empower the individuals to follow that debriefing exercise I mentioned. So, instead of just reporting

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Emily Isbell: what they did and their numbers and what they were proud of, or usually that is what people would highlight. We implemented a debriefing of their results. So where were they at in regards to being on track to their goals for the week? Were they on on track and forcing them in that structure of the end of day report to notice that they’re behind.

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Emily Isbell: And so they actually had to answer the question, What is their plan to improve the results? So that invaluable piece that I was referencing to the end of day got even more invaluable, because now my team is

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Emily Isbell: not micromanage, but managing themselves and reporting out on how they are going to hold themselves accountable to what they need to do to accomplish their goals without me ever having to say a word. And so it’s exciting, because

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Emily Isbell: you almost create these mini entrepreneurs of their own little business and their businesses, their department or business as their kpis and accomplishing them.

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Emily Isbell: And again, it’s not micromanagement, because they’re empowered to say, I recognize this. Here’s what I’m going to do. And you didn’t say what they needed to do, which is what a lot of leaders, home care and otherwise tend to do. They just go into problem solving entrepreneurs are problem solvers. And so they see a problem, and they go to solve it, and they dictate. I do like to use that word on purpose. They dictate a solution.

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Emily Isbell: and people don’t take well to dictatorship. And so, as much as you as the entrepreneur, the leader, think you’re being helpful because you’re like, I’m solving this problem, I’m helping you they subconsciously or consciously feel dictated to, and you don’t have a structure in place for them to feel empowered and then stress burnout things happen. So really the debriefing exercise to recognize where they’re at with regards to their goals

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Emily Isbell: and their actual results just truly empowered my team to be like I said, mini entrepreneurs who wanted the best for their department for their business within the overall organization. So most innovative thing was is creating little mini entrepreneurs from.

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Ruby Mehta: Yeah, yeah, I agree. 100%. Yes,

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Ruby Mehta: We have seen all of that in our experience in different organizations, leaders are problem solvers.

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Ruby Mehta: But yeah, they do try to impose their solution on you. So that’s there’s a fine line.

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Emily Isbell: And a couple things there. 1st of all, their solution may be the right solution that they want to impose.

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Emily Isbell: Okay, hold that there

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Emily Isbell: their solution may not be the best solution. And so what happens through these team members providing their plan is that you at the end of the day the buck still stops with you as the leader. And so maybe their plan is not pretty like it’s actually probably a really, maybe even a bad idea. You’re reviewing these. It’s not just to sit it and forget it and trust the process. You should be trusting, but verifying what they say and what they’re going to do.

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Emily Isbell: And so when they have a bad idea come across. Then, that’s when leadership steps into leadership of that person steps in. And you say, I like X about this. But let’s let’s kind of smooth out the edges and try to do this, or your experience comes into play. And you say, you know we did that

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Emily Isbell: multiple times, and every time it’s been a waste of finance resources, whatever the case is. And so you do bring yourself to the table as a leader. It’s not a lot of people going, rogue. When I talk about many entrepreneurs. It’s not a bunch of too many cooks in the kitchen or arrogance, but

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Emily Isbell: it does embrace an empowerment for them to problem solve. To maybe going back to that other point, have a better idea than you actually would as the leader, because you’re not necessarily always right. And your team, if you do leadership well, you actually surround yourself with people that are smarter than you, and bring more to the table about their specialty than you can. But the mixture of you both hopefully smooths out all the edges and makes it exceptional. Whatever the plan is.

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Ruby Mehta: Yeah, yeah, no. That’s that’s beautifully said, actually,

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Ruby Mehta: all right in in your role, since you managed more than one franchisee, and there are always challenges.

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Ruby Mehta: So we want to talk about the challenges a little bit, and also how you overcame those challenges, maintaining that high performance across the board.

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Emily Isbell: So I think
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Emily Isbell: the biggest one that sticks out to me at 1st is when in certain locations that had surprise audits, there was a time where one of my locations, or even maybe 2, was going through like 4 different audits, state contracting agencies that we partnered with just franchisor audit all at once.

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Emily Isbell: so that can be a challenge when you have multiple locations and you have multiple teams, and that is a cook. Many cooks in the kitchen. But I will say one of the things to combat that specifically the surprise audits, because I think the hardest part was the surprise piece where I’m in one location, and then I get a phone call and it says, Oh, the State just showed up.

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Emily Isbell: Thankfully. I had prepared for that and had a team member, the person who’s calling me to report that understood

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Emily Isbell: briefly what to do and didn’t make a mistake in that process. But over time I learned to create a more, a contingency plan of like having an sop for the second in command of the organization to know how to greet the auditor, where to set them up. What? To provide them. The culture of it to be friendly, to make sure that

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Emily Isbell: you didn’t upset them, start off on the wrong foot. But that was a big challenge to have multiple locations and to have a surprise audit by the State, and we always did well on. I was never concerned about our results of the audit, but

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Emily Isbell: audits are subjective at the end of the day. Yes, there’s a guide that they follow, but if they see a T. You know the idea of like cross your t’s and dot your i’s, and there’s not a dot there, but everything else is perfect. If you start off on the wrong foot, that I is a bigger deal than it might have been if you had actually presented well and prepared and together. So that was a challenge. You’ll get me on a soapbox there on Memory Lane. But

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Emily Isbell: another thing that was challenging with the different markets is that there are actually true market differentials, and that was hard for me. At 1st I technically went both ways. One day I would think it was not true, and then the next day I’d swing complete opposite and think everything has to be different here, just because of the challenges that would come up and the natural human behavior of our motions, but

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Emily Isbell: being able to filter out what is rinse and repeatable in certain locations, and then what’s not? And so the biggest challenge was figuring out rural markets compared to metro markets or compared to metro and rural markets, and how to recruit caregivers. In those it’d be very different. Some of the tactics we needed for metro areas versus our rural areas. And not only that.

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Emily Isbell: not only recruitment, but how we paid, how we charged. So those things were nuances that were challenges of leading from afar, and also leading multiple markets.

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Ruby Mehta: Yeah, yeah, no, that’s really. Those are the true

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Ruby Mehta: challenges. If you are not physically there. But you’re still managing things as if you are there. I think the one big thing is having second in command someone who can understand the value. And really, in your absence, take care of things that’s really important.

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Emily Isbell: Yup, and understand that responsibility. Not just a title.

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Emily Isbell: Yeah.

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Ruby Mehta: Okay, so let’s talk about your current organization, the one that you started. So tell our audience a little bit little bit about your company, and how you are helping others, and based on your experience with Homestead.

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Emily Isbell: Sure. So the shorter version of this is that I, in 2020 Covid, woke me up to realize. Not that I was unhappy in my role and unhappy being in the home care industry, but that I always had a dream of being an entrepreneur and owning my own business, that I had

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Emily Isbell: worked with the owner, built these businesses with that owner, and so very grateful for the investment and belief in me that that owner had. And but I’d always told him

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Emily Isbell: when I was when we 1st started working together, which I started young. I was 19 when I started at home instead, and I think our conversation around this was around 20 or 21 and all that. To say that when I started with him he knew I wanted to be an owner one day of something. At that time I thought a home instead, but

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Emily Isbell: so I told him I would do this until I was 45.

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Emily Isbell: Well, Covid happened like I mentioned, and it made me realize I might not make it to 45. The news reports we were seeing. I mean, we have to go a lot of us block that out, but we go back to a time where you’re seeing

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Emily Isbell: just horrible images of what Covid was doing across the world. And so, while I was grateful, we were considered essential, and that we had jobs and other friends were losing jobs and being laid off. I was grateful for that, but I also was like life is short. I don’t know that I want to wait. I may not make it till I’m 45. And so I

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Emily Isbell: I took a Sabbatical. I created a succession plan and worked with the owner to make sure I was replaced, and all of that went smoothly. I actually left the organization with the best performing month

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Emily Isbell: ever in my career for all the locations, and so I was really proud

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Emily Isbell: of of that. But I took a sabbatical, wasn’t sure what I wanted to do next. And in 2021

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Emily Isbell: I started this business, and it was because I was recognizing the need. I knew what I needed when I was overseeing operations and the support I needed that the franchisor just can’t provide legally. Truly, there are barriers with that. But beyond that

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Emily Isbell: I also wanted to to make sure and create a performance group. Support system for people like me. So all that to say we we do 2 different things

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Emily Isbell: primarily in our business, and the 1st one I want to talk about is our co-leadership, and any type of one-on-one consulting that I do with owners, I take an approach that I took with acquisitions. So my experience in the background, the way I was able to scale was we were acquiring existing home insteads and turning them around and improving the results in the different markets and growing them. And so I use that same approach that I used with

00:26:55.600 –> 00:27:20.329
Emily Isbell: acquisitions, but with owners. And this is their business. So it’s a little different, because when I would acquire. The owners were retiring or leaving the office, so I was able to just come in and do the changes necessary that I believed in. In this case I’m working with owners who this is their baby, and I’m not here to call it ugly at all, but at times I’m here to point

00:27:20.330 –> 00:27:27.670
Emily Isbell: out where it might be sick, and what we need to do to help make it feel better and work better, and to use that baby analogy. But

00:27:27.680 –> 00:27:36.680
Emily Isbell: ultimately there are things that owners find sacred. Sorry about, that. There are things that owners find sacred about, what their business

00:27:38.100 –> 00:28:00.869
Emily Isbell: what they do in their business, and I don’t want to mess with that. But I do want to point out where we can make improvements. So through co-leadership and the different one-on-one services we work to turn around their businesses while they’re still the owner. And sometimes that is a hope of it’s always a hope of increased hours and revenue growth all through quality services, quality, caregiving

00:28:00.870 –> 00:28:21.249
Emily Isbell: treatment. But then also, sometimes it’s a matter of just changing where they spend their time, how they’re working in the business versus on their business, and how to improve that and increase revenues and hours. The other thing that we do that I’m passionate about that I mentioned already is our powerhouse peers, and I often call it

00:28:21.360 –> 00:28:38.319
Emily Isbell: Performance Group, a performance group or a mastermind on steroids, because a lot of performance groups that are out there. There’s many across many different industries. Vistage is a popular one that’s just been around for a really long time. All of those are wonderful, but to me. They are

00:28:38.420 –> 00:28:39.790
Emily Isbell: they. They’re

00:28:40.020 –> 00:29:08.050
Emily Isbell: a wonderful group matchmaking service. And so they create a group, and they have some structure on how to evaluate your business with your peers, and how to be vulnerable with one another in those settings. But that’s not enough, in my opinion, and I think what we offer is the glue that brings it all together. And so we have facilitation where you work with a facilitator, one-on-one between those meetings that you’re utilizing an action plan. You don’t just sit and talk about what you need to do, and then go back to the office and

00:29:08.070 –> 00:29:29.940
Emily Isbell: get back to reality and think, yeah, right? That’s funny. I thought that I could do that, but I got to focus on the fact that there was a no call, no show today. So, avoiding some of those environmental barriers that prevent you from actually moving forward in your business. We try to combat that through our facilitation through the support of team. A team of 9 experts, including me. And

00:29:29.940 –> 00:29:42.219
Emily Isbell: what’s pretty cool and what’s been exciting about that is the results are showing. So we’re a relatively young business starting in 2021. But out of that time we’ve already seen that 88% of our members have

00:29:42.300 –> 00:30:00.259
Emily Isbell: had the highest grossing month revenue month that they’ve ever had once they become a member. And so it’s been a success. What I thought needed to be added and to make better has proven to be true, and it’s pretty exciting to watch our owners appreciate this value that we bring.

00:30:01.440 –> 00:30:25.599
Ruby Mehta: Awesome congratulations, Emily. And I hope with this, with this, podcast our audience got to learn from your experience and insight. So thank you so much for sharing that. And anybody who’s listening in. If you need advice, reach out to Emily. She’s already helping home care agency owners and operational staff so

00:30:25.670 –> 00:30:28.769
Ruby Mehta: reach out to her. Thank you so much, Emily, for your time.

00:30:28.770 –> 00:30:29.679
Emily Isbell: Thank you.

00:30:29.960 –> 00:30:30.699
Ruby Mehta: Thank you.